JMIR Publications

ABSTRACT

Background:

There is a growing interest in eHealth solutions to enhance access to and utilisation of pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD).

Objective:

To evaluate the feasibility of a novel eHealth tool to support pulmonary rehabilitation (Me&COPD) in terms of usability, exercise adherence, intensity, progression, and adverse events. An additional aim was to evaluate clinical outcome measures to prepare for a future larger trial.

Methods:

A multi-centre, parallel-group randomised controlled pilot- and feasibility trial was conducted in six primary healthcare centres. People with mild to severe COPD were recruited by physiotherapists (PTs) at the included healthcare centres and randomised either to the intervention group with access to Me&COPD for 3 months or to control group receiving usual care. Me&COPD comprises audio-visual and written self-management strategies, including an individually tailored, home-based, physical exercise program and interaction with a PT. The exercise program is prescribed in a face-to-face meeting with a PT and thereafter regularly reviewed and progressed through the eHealth tool. The primary outcome, usability, was self-assessed at intervention completion in the intervention group and among participating PTs (n=7) using the Swedish version of the mHealth App Usability Questionnaire (S-MAUQ). In addition, usage data on exercise adherence, intensity, and progression, and adverse events were exported from the eHealth tool. Clinical outcomes, assessed by blinded assessors at baseline and 3 months in intervention and control groups, included exercise capacity, balance, physical activity level, COPD-related symptoms, and health-related quality of life. Descriptive statistics were used for analysis.

Results:

In total, 22 participants (55% women), mean (SD) age 72.3 (8.4) years were included in intervention (n=15) and control groups (n=7). Mean (SD) overall S-MAUQ scores were 4.4 (1.5) for participants and 4.5 (1.2) for PTs out of 7 (highest possible usability). Among the subscales, the highest score was assigned to “Usefulness” both among the participants: mean (SD) score 4.9 (1.3) as well as the PTs: 5.1 (1.7). Usage data showed that no severe adverse events were registered, although exercise adherence, intensity, and progression evaluation was limited by incomplete exercise session registration. The test procedures and the clinical outcome measures used were found to be feasible for the participants as well as the assessors.

Conclusions:

The novel eHealth tool, Me&COPD, seemed feasible in terms of safety and acceptable usability in people with COPD and in participating PTs. The usability may be additionally improved by better organisation of the information and simplification of the exercise diary to enable collection of data on exercise adherence, intensity, and progression through the eHealth tool. The test procedures seemed feasible, although the recruitment process needs further consideration. The effectiveness of the intervention remains to be evaluated in a future larger trial. Clinical Trial: Clinical Trials.gov NCT05086341, https://clinicaltrials.gov/study/NCT05086341?cond=copd&term=eHealth&rank=1